Efficacy and safety evaluation of teicoplanin on hospital-acquired pneumonia with renal dysfunction.

OBJECTIVE To evaluate the efficacy and safety of teicoplanin for the treatment of patients with hospital acquired pneumonia with renal dysfunction.METHODS In the randomized,controlled clinical trial all 76 patients(males 54 and females 22 with mean of 76.5±14.3 years old)with established meticillin-resistant Staphylococcus aureus(MRSA) and/or meticillin-resistant S.epidermidis(MRSE) infections were enrolled,and divided randomly into teicoplanin group and vancomycin group.Based on creatinine clearance(Ccr)to calculate the dose and the dosage interval,and serum concentrations of teicoplanin and varcomycin were monitored.Clinical effectiveness,bacteriologic eradication rate,renal functional parameters and adverse effects were evaluated.RESULTS The total clinical effectiveness and bacteriologic eradication rate were 82.5% and 84.8%,respectively for teicoplunin group vs 75% and 79.2% for vancomycin group,but without significant differences between them groups.However,the mean time of treatment course in teicoplanin group was significantly shorter than the vancomycin group(13.5±2.7 days vs 20.3±5.6 days),t=5.47,P=0.032.10% adverse drug reactions occurred in teicoplanin group and 16.7% in vancomycin group with out significant differences.But compared with nephrotoxicity exclusively,the teicoplanin group was significantly lower than the vancomycin group,χ2=5.9468,P=0.0147.CONCLUSIONS Teicoplanin is a very effective antibiotic for MRSA/MRSE infections in patients with renal dysfunction.It is rational and safe that teicoplanin should be administered at a maintaining dose of 400mg at 48-72h intervals in renal dysfunction patients.Teicoplanin may be a choice for initial empirical treatment on infections of MRSA/MRSE in patients with renal dysfunction.